Provider Demographics
NPI:1861487514
Name:HAROUN, RAYMOND ISAAC (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:ISAAC
Last Name:HAROUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 WILKENS AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5072
Mailing Address - Country:US
Mailing Address - Phone:410-646-4800
Mailing Address - Fax:410-646-9700
Practice Address - Street 1:3407 WILKENS AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5072
Practice Address - Country:US
Practice Address - Phone:410-646-4800
Practice Address - Fax:410-646-9700
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD53752207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
3653121OtherAETNA HMO
038-889OtherEHP/PRIORITY PARTNERS
7609144OtherAETNA PPO
336403OtherMAMSI
1985692OtherUNITED HEALTHCARE
6310941OtherCIGNA MANAGED CARE
MD633102500Medicaid
MD997MMedicare PIN
7609144OtherAETNA PPO